Belated awareness at the international level

Since the first case of AIDS was identified in sub-Saharan Africa in the district of Rakai in Uganda in 1982 Serwadda, Mugerwa et al., 1985, the epidemic has spread and killed a considerable number of people: an estimated 20 million people around the world have died of AIDS since the onset of the epidemic twenty years ago UNAIDS, 2004.

Adult mortality began to increase rapidly in the 90s in sub-Sahara Africa due to AIDS and thus the number of orphans has significantly risen from an estimated 550 thousand orphans in 1990 to an estimated 12.3 million in 2003 UNICEF, UNAIDS et al., 2004.

The first studies on HIV/AIDS in Africa focused on behavioural aspects, transmission issues, AIDS progression rates, and the treatments provided to patients Serwadda, Wawer et al., 1992, McGrath, Rwabukwali et al., 1993. Later, it emphasised the economic implications of HIV and the impact of HIV on the health care system and mortality Gregson, Garnett et al., 1994, Goldfarb, 1991, Hassig, Perriens et al., 1990, Mulder, Nunn et al., 1994, Persson, 1994, De Cock, 1994, Cabral, 1993.

The first studies regarding the support of AIDS orphans were conducted in the early 90s. Pioneering work on orphans in Uganda was led by Hunter (1990) who was alarmed about the high proportions of orphans within the population and had predicted that the traditional support system of the extended family could not cope adequately with this problem Hunter, 1990. Barnett et al. (1992) argued, based on a study carried out in the district of Rakaï in Uganda, that most orphans cared for by the extended family were deprived of education, parental protection, adequate nutrition, shelter, clothes, and legal protection regarding the parents’ property Barnett and Blaikie, 1992. However, these studies were carried out at the onset of the epidemic.

Little by little, empirical data from Uganda Kamali, Seeley et al., 1996 and Zimbabwe Foster, Shakespeare et al., 1995, as well as simulations Gregson, Garnett et al., 1994 indicated the large-scale  orphan phenomenon related to the AIDS epidemic.

More detailed studies on AIDS orphans were conducted in Mutare in Zimbabwe in an area of high AIDS prevalence Foster, Shakespeare et al., 1995, Foster, 1996. (Zimbabwe was one of the worst affected countries in sub-Sahara African countries in 2003 with an HIV/AIDS prevalence of 24.6%) United Nations, 2005.

The extent of the orphan crisis has thus been shown by increasingly alarming projections of the number of orphans but also by studies indicating the limits of support mechanisms and adequate care structures for orphans.

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